[1]韩怡波.儿童急淋大剂量甲氨蝶呤延迟解救的安全性研究[J].医学信息,2019,(19):143-145148.[doi:10.3969/j.issn.1006-1959.2019.19.046]
 HAN Yi-bo.Safety Study on Delayed Rescue of High-Dose Methotrexate in Children[J].Medical Information,2019,(19):143-145148.[doi:10.3969/j.issn.1006-1959.2019.19.046]
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儿童急淋大剂量甲氨蝶呤延迟解救的安全性研究()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
期数:
2019年19期
页码:
143-145148
栏目:
药物与临床
出版日期:
2019-10-01

文章信息/Info

Title:
Safety Study on Delayed Rescue of High-Dose Methotrexate in Children
文章编号:
1006-1959(2019)19-0143-04
作者:
韩怡波
(大连市妇女儿童医疗中心儿童血液肿瘤科,辽宁 大连 116034)
Author(s):
HAN Yi-bo
(Department of Children Pediatric Hematological Oncology,Dalian Municipal Women and Children′s Medical Center,Dalian 116034,Liaoning,China)
关键词:
甲氨蝶呤亚叶酸钙儿童急性淋巴细胞白血病
Keywords:
MethotrexateCalcium leucovorinChildrenAcute lymphoblastic leukemia
分类号:
R733.71
DOI:
10.3969/j.issn.1006-1959.2019.19.046
文献标志码:
A
摘要:
目的 探讨大剂量使用甲氨蝶呤(HD-MTX)治疗儿童急性淋巴细胞白血病(ALL)后延迟6 h解救的安全性。方法 选择2006年1月~2018年12月在我院接受治疗的中高危ALL患儿108例作为研究对象,所有患儿均接受HD-MTX治疗,根据开始使用亚叶酸钙(CF)解救时间分为36H组及42H组,各54例。比较两组患儿的临床表现、常见不良反应情况及第2、3次解救后血药浓度。结果 36H组患儿骨髓抑制、口腔黏膜损害、胃肠道反应、肝功能异常、皮疹、继发感染发生率分别为81.48%(44/54)、20.37%(11/54)、24.07%(13/54)、44.44%(24/54)、11.11%(6/54)、11.11%(6/54),42H组分别为88.89%(48/54)、12.96%(7/54)、16.67%(9/54)、51.85%(28/54)、7.41%(4/54)、9.26%(5/54),组间比较,差异无统计学意义(P>0.05);两组第2、3次解救后血药浓度比较,差异无统计学意义(P>0.05)。结论 ALL患儿接受HD-MTX治疗后42 h解救与36 h解救的安全性基本一致,但延迟6 h解救可以更好的发挥MTX的抗肿瘤作用。
Abstract:
Objective To investigate the safety of high-dose methotrexate (HD-MTX) in the treatment of children with acute lymphoblastic leukemia (ALL) after 6 h of rescue. Methods From January 2006 to December 2018, 108 children with middle and high risk ALL treated in our hospital were selected as the subjects. All the children were treated with HD-MTX. According to the rescue time of calcium folinate (CF), they were divided into 36H group (n=54) and 42H group (n=54). The clinical manifestations, common adverse reactions and blood concentration were compared between the two groups.Results The incidence of bone marrow suppression, oral mucosal damage, gastrointestinal reactions, liver dysfunction, rash and secondary infection in the 36H group were 81.48%(44/54)、20.37%(11/54)、24.07%(13/54)、44.44%(24/54)、11.11%(6/54)、11.11%(6/54), 42H group, respectively. The differences were 88.89%(48/54)、12.96%(7/54)、16.67%(9/54)、51.85%(28/54)、7.41%(4/54)、9.26%(5/54), respectively. There was no significant difference between the two groups (P>0.05). There was no significant difference in blood concentration between the two groups at the 2nd and 3rd time (P>0.05).Conclusion The safety of 42 h after HD-MTX treatment was consistent with the safety of 36 h rescue in children with ALL, but delayed 6 h rescue could better exert the anti-tumor effect of MTX.

参考文献/References:

[1]谭惠珍,柯志勇,张映川,等.脑脊液流式细胞学检测技术鉴别小儿急性淋巴细胞白血病并发中枢神经系统疾病应用价值探讨(附7例报告)[J].中国实用儿科杂志,2016,45(2):127-130. [2]Xiao J,Zhou H,Wu N,et al.The non-canonical Wnt pathway negatively regulates dendritic cell differentiation by inhibiting the expansion of Flt3(+)lymphocyte-primed multipotent precursors[J].Cell Mol Immunol,2016,13(5):593-604. [3]田佳懿,刘俊丽,王淑梅,等.大剂量甲氨蝶呤注射剂化疗导致急性淋巴细胞白血病患儿贫血的相关因素分析[J].中国临床药理学杂志,2016,32(20):1908-1910. [4]李菲,尹郸丹,周小兰,等.急性淋巴细胞白血病患儿GSTP1及MTHFR基因多态性对大剂量甲氨蝶呤不良反应的影响[J].中国实验血液学杂志,2017,25(3):723-728. [5]Xie S,Jiang H,Zhai XW,et al.Antitumor action of CDK inhibitor LS-007 as a single agent and in combination with ABT-199 against human acute leukemia cells[J].Acta Pharmacol Sin,2016,37(11):1481-1489. [6]王淑梅,孙路路,杨平,等.大剂量甲氨蝶呤注射剂化疗导致急性淋巴细胞白血病患儿白细胞减少的危险因素分析[J].中国临床药理学杂志,2016,32(20):1905-1907. [7]党旭红,张睿凤,刘红艳,等.56Fe17+、12C6+重离子束照射后人淋巴细胞基因转录谱的改变[J].中华放射医学与防护杂志,2016, 36(8):577-582. [8]胡川,徐刚.甲氨蝶呤代谢相关酶基因多态性与大剂量甲氨蝶呤治疗儿童急性淋巴细胞白血病中不良反应的相关性研究[J].实用药物与临床,2017,20(7):840-844.

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更新日期/Last Update: 2019-10-01